Evaluation Factors Affect Difficult Intravenous Access in the Prehospital Setting
-
Ehsan Karimialavijeh
,
Hossein Kermanpour
,
Sima Bijani
,
Mozhgan Sadat Hashemi
,
Pooya Payandemehr
,
Kamran Shirbache
,
Ghasem Pishgahi
Abstract
Background: Environmental factors such as the lighting of the scene, time of the day, and physical surrounding of the patient and healthcare providers in the prehospital setting can affect difficult intravenous access (DIVA). The study aimed to evaluate the association of environment, patient, and emergency medical services (EMS) technicians on the DIVA in the prehospital setting.
Methods: Six-hundred adult patients (aged ≥18 years) who necessitated prehospital peripheral IV access and were transferred to the Sina and Shariati hospitals by EMS technicians from June 2018 to October 2018 were included. There were seven research nurses for interviewing the EMS technicians. Patients were examined using the prepared checklists.
Results: Overall, there were 125 (20.83%) DIVA cases. There was a significant relationship between DIVA and the higher respiratory rate of the patients, lower the blood pressure of the patient, prior cannulation of the targeted limb, time since the last meal of EMS technician, and untidiness of the environment (Odds Ratio=1.75, 1.3, 9.4, 3.84 and 7.01, respectively).
Conclusion: The results showed fasting of EMS technicians affects DIVA and the study suggests it can be resolved by proper scheduling of the working hours of EMS technicians. Also, some risk factors of DIVA can help the paramedics to predict the DIVA and take the necessary measures.
[1] Piredda M, Biagioli V, Barrella B, Carpisassi I, Ghinelli R, Giannarelli D, et al. Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study. J Clin Nurs. 2017; 2017; 26(7-8):1074-1084.
[2] Piredda M, Fiorini J, Facchinetti G, Biagioli V, Marchetti A, Conti F, et al. Risk factors for a difficult intravenous access: A multicentre study comparing nurses’ beliefs to evidence. J Clin Nurs. 2019; 28(19-20):3492-3504.
[3] Ehrhardt BS, Givens KEA, Lee RC. Making it stick: Developing and testing the Difficult Intravenous Access (DIVA) tool. Am J Nurs. 2018; 118(7):56-62.
[4] Armenteros-Yeguas V, Gárate-Echenique L, Tomás-López MA, Cristóbal-Domínguez E, Moreno-de Gusmão B, Miranda-Serrano E, et al. Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients. J Clin Nurs. 2017; 26(23-24):4267-4275.
[5] Prottengeier J, Albermann M, Heinrich S, Birkholz T, Gall C, Schmidt J. The prehospital intravenous access assessment: A prospective study on intravenous access failure and access delay in prehospital emergency medicine. Eur J Emerg Med. 2016; 23(6):442-447.
[6] Jacobson AF, Winslow EH. Variables influencing intravenous catheter insertion difficulty and failure: An analysis of 339 intravenous catheter insertions. Hear Lung J Acute Crit Care. 2005; 34(5):345-59.
[7] van Loon F, van Hooff L, de Boer H, Koopman S, Buise M, Korsten H, et al. The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019; 8(2):144.
[8] Fields JM, Dean AJ, Todman RW, Au AK, Anderson KL, Ku BS, et al. The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity. Am J Emerg Med. 2012; 30(7):1134-40.
[9] Van Loon FHJ, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA scale: A clinical predictive scale to identify difficult intravenous access in adult patients based on clinical observations. Med (United States). 2016; 95(16):e3428.
[10] Yen K, Riegert A, Gorelick MH. Derivation of the DIVA score: A clinical prediction rule for the identification of children with difficult intravenous access. Pediatr Emerg Care. 2008; 24(3):143-7.
[11] Au AK, Rotte MJ, Grzybowski RJ, Ku BS, Fields JM. Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. Am J Emerg Med. 2012; 30(9):1950-4.
[12] Schoenfeld E, Boniface K, Shokoohi H. ED technicians can successfully place ultrasound-guided intravenous catheters in patients with poor vascular access. In: American Journal of Emergency Medicine. 2011; 29(5):496-501.
[13] Prottengeier J, Maier JN, Gall C, Heinrich S, Schmidt J, Birkholz T. Does it matter who places the intravenous? An inter-professional comparison of prehospital intravenous access difficulties between physicians and paramedics. Eur J Emerg Med. 2017; 24(6):443-449.
[14] Sebbane M, Claret PG, Lefebvre S, Mercier G, Rubenovitch J, Jreige R, et al. Predicting peripheral venous access difficulty in the Emergency Department using body mass index and a clinical evaluation of venous accessibility. J Emerg Med. 2013; 44(2):299-305.
[15] Fields JM, Piela NE, Au AK, Ku BS. Risk factors associated with difficult venous access in adult ED patients. Am J Emerg Med. 2014; 32(10):1179-82.
[16] Chiricolo G, Balk A, Raio C, Wen W, Mihailos A, Ayala S. Higher success rates and satisfaction in difficult venous access patients with a guide wire-associated peripheral venous catheter. Am J Emerg Med. 2015; 33(12):1742-4.
[17] Gallieni M, Pittiruti M, Biffi R. Vascular Access in Oncology Patients. CA Cancer J Clin. 2008; 58(6):323-46.
[18] Pomero F, Di Minno MND, Fenoglio L, Gianni M, Ageno W, Dentali F. Is diabetes a hypercoagulable state? A critical appraisal. Acta Diabetologica. 2015. 52(6):1007-16.
[19] Brannam L, Blaivas M, Lyon M, Flake M. Emergency nurses’ utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients. Acad Emerg Med. 2004; 11(12):1361-3.
[20] Costantino TG, Kirtz JF, Satz WA. Ultrasound-guided peripheral venous access vs. the external jugular vein as the initial approach to the patient with difficult vascular access. J Emerg Med. 2010; 39(4):462-7.
[21] de la Torre-Montero JC, Montealegre-Sanz M, Faraldo-Cabana A, Oliva-Pellicer B, García-Real I, Fenwick M, et al. Venous International Assessment, VIA scale, validated classification procedure for the peripheral venous system. J Vasc Access. 2014; 15(1):45-50.
[22] Lapostolle F, Catineau J, Garrigue B, Monmarteau V, Houssaye T, Vecci I, et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007; 33(8):1452-7.
[23] Patterson PD, Buysse DJ, Weaver MD, Suffoletto BP, McManigle KL, Callaway CW, et al. Emergency healthcare worker sleep, fatigue, and alertness behavior survey (SFAB): Development and content validation of a survey tool. Accid Anal Prev. 2014; 73:399-411.
[24] Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2013; 23(1-2):93-108.
[25] Yalçınlı S, Akarca FK, Can Ö, Şener A, Akbinar C. Factors affecting the first-attempt success rate of intravenous cannulation in older people. J Clin Nurs. 2019; 28(11-12):2206-2213.
[26] Matthew Fields J, Piela NE, Ku BS. Association between multiple IV attempts and perceived pain levels in the emergency department. J Vasc Access. 2014; 15(6):514-8.
[2] Piredda M, Fiorini J, Facchinetti G, Biagioli V, Marchetti A, Conti F, et al. Risk factors for a difficult intravenous access: A multicentre study comparing nurses’ beliefs to evidence. J Clin Nurs. 2019; 28(19-20):3492-3504.
[3] Ehrhardt BS, Givens KEA, Lee RC. Making it stick: Developing and testing the Difficult Intravenous Access (DIVA) tool. Am J Nurs. 2018; 118(7):56-62.
[4] Armenteros-Yeguas V, Gárate-Echenique L, Tomás-López MA, Cristóbal-Domínguez E, Moreno-de Gusmão B, Miranda-Serrano E, et al. Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients. J Clin Nurs. 2017; 26(23-24):4267-4275.
[5] Prottengeier J, Albermann M, Heinrich S, Birkholz T, Gall C, Schmidt J. The prehospital intravenous access assessment: A prospective study on intravenous access failure and access delay in prehospital emergency medicine. Eur J Emerg Med. 2016; 23(6):442-447.
[6] Jacobson AF, Winslow EH. Variables influencing intravenous catheter insertion difficulty and failure: An analysis of 339 intravenous catheter insertions. Hear Lung J Acute Crit Care. 2005; 34(5):345-59.
[7] van Loon F, van Hooff L, de Boer H, Koopman S, Buise M, Korsten H, et al. The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019; 8(2):144.
[8] Fields JM, Dean AJ, Todman RW, Au AK, Anderson KL, Ku BS, et al. The effect of vessel depth, diameter, and location on ultrasound-guided peripheral intravenous catheter longevity. Am J Emerg Med. 2012; 30(7):1134-40.
[9] Van Loon FHJ, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA scale: A clinical predictive scale to identify difficult intravenous access in adult patients based on clinical observations. Med (United States). 2016; 95(16):e3428.
[10] Yen K, Riegert A, Gorelick MH. Derivation of the DIVA score: A clinical prediction rule for the identification of children with difficult intravenous access. Pediatr Emerg Care. 2008; 24(3):143-7.
[11] Au AK, Rotte MJ, Grzybowski RJ, Ku BS, Fields JM. Decrease in central venous catheter placement due to use of ultrasound guidance for peripheral intravenous catheters. Am J Emerg Med. 2012; 30(9):1950-4.
[12] Schoenfeld E, Boniface K, Shokoohi H. ED technicians can successfully place ultrasound-guided intravenous catheters in patients with poor vascular access. In: American Journal of Emergency Medicine. 2011; 29(5):496-501.
[13] Prottengeier J, Maier JN, Gall C, Heinrich S, Schmidt J, Birkholz T. Does it matter who places the intravenous? An inter-professional comparison of prehospital intravenous access difficulties between physicians and paramedics. Eur J Emerg Med. 2017; 24(6):443-449.
[14] Sebbane M, Claret PG, Lefebvre S, Mercier G, Rubenovitch J, Jreige R, et al. Predicting peripheral venous access difficulty in the Emergency Department using body mass index and a clinical evaluation of venous accessibility. J Emerg Med. 2013; 44(2):299-305.
[15] Fields JM, Piela NE, Au AK, Ku BS. Risk factors associated with difficult venous access in adult ED patients. Am J Emerg Med. 2014; 32(10):1179-82.
[16] Chiricolo G, Balk A, Raio C, Wen W, Mihailos A, Ayala S. Higher success rates and satisfaction in difficult venous access patients with a guide wire-associated peripheral venous catheter. Am J Emerg Med. 2015; 33(12):1742-4.
[17] Gallieni M, Pittiruti M, Biffi R. Vascular Access in Oncology Patients. CA Cancer J Clin. 2008; 58(6):323-46.
[18] Pomero F, Di Minno MND, Fenoglio L, Gianni M, Ageno W, Dentali F. Is diabetes a hypercoagulable state? A critical appraisal. Acta Diabetologica. 2015. 52(6):1007-16.
[19] Brannam L, Blaivas M, Lyon M, Flake M. Emergency nurses’ utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients. Acad Emerg Med. 2004; 11(12):1361-3.
[20] Costantino TG, Kirtz JF, Satz WA. Ultrasound-guided peripheral venous access vs. the external jugular vein as the initial approach to the patient with difficult vascular access. J Emerg Med. 2010; 39(4):462-7.
[21] de la Torre-Montero JC, Montealegre-Sanz M, Faraldo-Cabana A, Oliva-Pellicer B, García-Real I, Fenwick M, et al. Venous International Assessment, VIA scale, validated classification procedure for the peripheral venous system. J Vasc Access. 2014; 15(1):45-50.
[22] Lapostolle F, Catineau J, Garrigue B, Monmarteau V, Houssaye T, Vecci I, et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007; 33(8):1452-7.
[23] Patterson PD, Buysse DJ, Weaver MD, Suffoletto BP, McManigle KL, Callaway CW, et al. Emergency healthcare worker sleep, fatigue, and alertness behavior survey (SFAB): Development and content validation of a survey tool. Accid Anal Prev. 2014; 73:399-411.
[24] Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed attempts and improvement strategies in peripheral intravenous catheterization. Biomed Mater Eng. 2013; 23(1-2):93-108.
[25] Yalçınlı S, Akarca FK, Can Ö, Şener A, Akbinar C. Factors affecting the first-attempt success rate of intravenous cannulation in older people. J Clin Nurs. 2019; 28(11-12):2206-2213.
[26] Matthew Fields J, Piela NE, Ku BS. Association between multiple IV attempts and perceived pain levels in the emergency department. J Vasc Access. 2014; 15(6):514-8.
| Files | ||
| Issue | Vol 8 No 4 (2022): Autumn |
|
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/aacc.v8i4.10181 | |
| Keywords | ||
| Difficult intravenous access prehospital Medical services | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Karimialavijeh E, Kermanpour H, Bijani S, Sadat Hashemi M, Payandemehr P, Shirbache K, Pishgahi G. Evaluation Factors Affect Difficult Intravenous Access in the Prehospital Setting. Arch Anesth & Crit Care. 2022;8(4):318-324.
